Objectives: To investigate the clinical features of viral encephalitis in children at acute stage, and the relationship of these clinical features with post viral encephalitic epilepsy.
Methods: The children with viral encephalitis treated in West China Second University Hospital between January 2010 and January 2014 were enrolled. The clinical features included general conditions, clinical manifestations, video electroencephalogram (VEEG), neuroimaging, virology, prognosis and antiepileptic drugs. The logistic regression model analysis was utilized to analyze the risk factors for the occurrence, bad control, and poor prognosis of post viral encephalitic epilepsy.
Results: Total 506 children with viral encephalitis were enrolled. Of these, 58(11.46%)developed epilepsy with a follow-up period more than 1.5 years. The logistic regression analysis showed that the risk factors were repetitive seizures (SB =3.602), detection of clinical seizures in EEG (SB =3.061), status epilepticus (SB =2.711) and mental/behavior disorder (SB =1.850). Among 58 epilepsy cases, 40(74.07%) had favorable seizure control, including 37 cases (92.5%) using no more than two kinds of antiepileptic drugs. With Glasgow Outcome Scale, 24 patients (41.38%) had poor prognosis, including 20 cases of intellectual and psychomotor retardation (83.33%), 3 cases of language disorders (12.50%), 1 case of hearing impairment (4.17%), 3 cases of limb dysfunction (12.50%), 3 cases of mortalities (12.50%). Single factor analysis suggested status epilepticus in acute phase had more chance to poor prognosis, but this was not confirmed by logistic regression analysis.
Conclusion: The risk factors of post viral encephalitic epilepsy in pediatric patients comprise the mental/behavior disorder, repetitive seizures, status epilepticus, and detection of clinical seizures during VEEG monitoring. The risk factors of poor prognosis remain unclear.
Keywords: Epilepsy; Pediatrics; Prognosis; Risk factors; Viral encephalitis.